Benztropine: Difference between revisions
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Latest revision as of 21:56, 20 March 2026
Administration
- Type: Anticholinergic
- Dosage Forms: tablet, injectable solution
- Dosage Strengths: tablet: 0.5, 1, 2mg; injectable solution: 1mg/mL
- Routes of Administration: IV, IM, oral
- Common Trade Names: Cogentin
Adult Dosing
- Extrapyramidal disease: 1-4 mg IV/IM/PO 1-2 times daily
- Parkinsonism: 0.5 mg IM/IV/PO daily, titrate up in 0.5mg increments
Pediatric Dosing
- Contraindicated children <3 years old. Otherwise, same as adult dosing
Special Populations
- Pregnancy Rating: B
- Lactation risk: Infant risk cannot be ruled out
- Renal: no adjustment
- Hepatic: no adjustment
Contraindications
- Allergy to class/drug
- Age <3 years
Adverse Reactions
Serious
- Psychosis, confusion, hallucinations
- Hyperpyrexia, heat stroke, anhidrosis
- Paralytic ileus
Common
- Tachycardia
- Constipation, nausea, xerostomia
- Blurry vision
- Urinary retention
Pharmacology
- Half-life: duration of action is around 24 hours
- Metabolism:
- Excretion:
Mechanism of Action
- Anticholinergic, reduces imbalance between acetylcholine and dopamine
Comments
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Akathisia | 1-2mg IV | Anticholinergic, first-line | IV | Adult |
| Antipsychotic toxicity | 1-2mg IV/IM | Dystonic reaction, alternative | IV/IM | Adult |
| Dystonic reaction | 1-2mg IV over 2 min | Anticholinergic, first-line | IV | Adult |
| Extrapyramidal reaction | 1-2mg PO or IV/IM | Anticholinergic for acute dystonia/akathisia | PO/IV/IM | Adult |
See Also
References
- 2019 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019;67(4):674-694. doi: 10.1111/jgs.15767. [PubMed 30693946]
- Bellman MH. Treatment of phenothiazine drug intoxication with benztropine. Arch Dis Child.1974;49(8):664-665. [PubMed 4424791]
- Benztropine tablets [prescribing information]. Livonia, MI: Major Pharmaceuticals; October 2017.
- Brocks DR. Anticholinergic drugs used in Parkinson's disease: An overlooked class of drugs from a pharmacokinetic perspective. J Pharm Pharm Sci. 1999;2(2):39-46. [PubMed 10952768]
- Cogentin (benztropine) injection [prescribing information]. Lake Forest, IL: Akorn Inc; May 2013.
- Duncan MA, Nikolov NM, and O’Kelly B, “Acute Chorea Due to Ondansetron in an Obstetric Patient,” Int J Obstet Anesth, 2001, 10(4):309-11. [PubMed 15321589]
- Falterman CG, Richardson CJ. Small left colon syndrome associated with maternal ingestion of psychotropic drugs. J Pediatr. 1980;97(2):308-310. [PubMed 740090]
- Habre W, Wilson D, Johnson CM. Extrapyramidal side-effects from droperidol mixed with morphine for patient-controlled analgesia in two children. Paediatr Anaesth. 1999;9(4):362-364. [PubMed 10411778]
- Joseph MM, King WD. Dystonic reaction following recommended use of a cold syrup. Ann Emerg Med. 1995;26(6):749-751. [PubMed 7492048]
- Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB; Schizophrenia Patient Outcomes Research Team (PORT). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophr Bull. 2010;36(1):94-103. doi: 10.1093/schbul/sbp130. [PubMed 19955388]